Week in Review

Hipkins starts to make his mark

He has been in the job less than a week, but new Health Minister Chris Hipkins is already making his presence felt on some critical Covid-19 issues, Sam Sachdeva writes

When it was revealed Chris Hipkins would replace David Clark as Health Minister, some observers wondered whether the role may stretch him too far.

After all, Hipkins already has the education and state services portfolios, both meaty roles, and with the former in particular requiring oversight of a good amount of operational work.

Jacinda Ardern pointed to that experience as the reason for giving him the job, and while it is still incredibly early days, she has little reason to doubt her pick so far.

With Director-General of Health Ashley Bloomfield taking an overdue holiday, the stage was clear for Hipkins to share the latest infection and testing numbers.

And while he may be a caretaker, the minister quickly showed he wasn’t afraid of getting deep into the weeds.

Hipkins said he had asked officials to ensure there was “an enhanced rate of testing” in the coming days, with daily test numbers which not that long ago touched five figures down to just 1641 on Monday.

“The number of tests that you will have seen processed in recent days does not meet the Government’s expectations,” he said bluntly.

Hipkins is not the only one to be unhappy: on Monday, Newsroom reported on confusion among clinicians and members of the public alike regarding a change to the Covid-19 case definition which led to people with Covid-like symptoms, but who did not meet the new higher index of suspicion (HIS) criteria, being turned away.

Hipkins appeared reluctant to be seen as meddling in medical decisions, saying he was “not trying to instruct doctors on who should be tested”.

But clinical judgment being disregarded appears to explain at least some of the drop in testing.

As reported by Newsroom, GPs have spoken of exercising their discretion to refer a patient for testing since the new criteria came into effect - only for the people to then be turned away from the CBACs.

It seems a similar story to the early days of New Zealand’s lockdown, when Ardern rolled out a mantra of “test, test, test” following complaints from Kiwis who were turned away despite a medical recommendation they be tested.

David Clark's confidence seemed to desert him in his last weeks as Health Minister. File photo: Lynn Grieveson

Deferring to the wisdom of medical practitioners is sound in principle, but it is when different clinicians diverge in their views that a heavier hand from the state may be required.

Hipkins’ public dissatisfaction may itself be enough to start an upwards trend, but he also implied the clinical criteria may change as a result of the dropping test rates.

Such a change will ultimately be up to the Ministry of Health, but with a close correlation between the tightening of the criteria on June 24 (when a record 10,436 tests were completed) and the declining numbers, they at least have cause for a second look.

A daily rate of about 4000 tests, spread around the country and including surveillance testing, appears to be the “magic number” which can provide confidence that community transmission isn’t going undetected without needlessly diverting GPs and other health professionals from their normal work.

Hipkins has also requested a more thorough breakdown of testing rates to distinguish between those taking place at the border, for workers who are exempt from isolation requirements, and those in the community - raising the question of why that was not available in the first place.

He tried not to rub salt in the all too fresh wound of his predecessor, insisting Clark had also been asking questions about testing rates and noting that “a fresh set of eyes” would naturally ask different questions.

But Hipkins’ confidence in fielding tricky questions, a feeling which seemed to ebb away from Clark in the weeks leading up to his resignation, served as a vindication of Ardern’s decision.

There’s still plenty of time for things to go wrong between now and September 19, particularly if any plans to further open up the border gain momentum.

But for now, Hipkins has showed he may well be up to the role full-time in a second term - provided Labour gets it, and he wants it.

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